Overview

This is an overview of the general format of the Medicare Physician Fee Schedule (MPFS), specifically the PFS Relative Value File.

The “file” is a zip archive and typically contains six files. Updates are released on the first day of each quarter. If required, a correction notice may be issued. The following naming convention is used:

naming_convention	release_schedule
File Naming Convention Release Schedule
RVU[YY]A.zip	Q1: January 1^st
RVU[YY]AR.zip	Q1: January ?? Correction Notice (If Required)
RVU[YY]B.zip	Q2: April 1^st
RVU[YY]C.zip	Q3: July 1^st
RVU[YY]D.zip	Q4: October 1^st

	file	contents
1	RVU[YY][VER]	Data Dictionary, Record Layout and File Documentation
2	PPRRVU[YY]	Physician Fee Schedule RVUs and Policy Indicators
3	GPCI[YYYY]	Geographic Practice Cost Index Components for each Carrier/Locality combination
4	[YY]LOCCO	Locality to County Crosswalk
5	ANES[YYYY]	Anesthesia Conversion Factors
6	OPPSCAP	OPPS-based capitation-adjusted payment amounts. Carrier-priced codes contain the OPPS-based payment capitation only. Carrier prices cannot exceed this capitation.

	mean	sd	p75	p100
work_rvu	3.88	8.51	3.21	108.91
non_fac_pe_rvu	4.01	10.52	5.35	355.87
facility_pe_rvu	3.03	5.60	3.66	53.07
mp_rvu	0.83	2.20	0.43	28.99
non_facility_total	8.71	18.07	9.79	364.53
facility_total	7.74	15.57	7.50	171.00
pre_op	0.02	0.04	0.00	0.17
intra_op	0.17	0.32	0.00	0.84
post_op	0.03	0.07	0.00	0.23
conv_factor	32.74	0.00	32.74	32.74
non_facility_pe_used_for_opps_payment_amount	0.90	7.15	0.00	159.54
facility_pe_used_for_opps_payment_amount	0.90	7.15	0.00	159.54
mp_used_for_opps_payment_amount	0.01	0.06	0.00	1.83

	na	pct_cmp	min	max	unique
hcpcs	0	100%	5	5	16324
mod	16323	12%	2	2	3
description	1	100%	3	28	14376
status_code	0	100%	1	1	12
not_used_for_medicare_payment	18366	1%	1	1	1
non_fac_indicator	14433	22%	2	2	1
facility_indicator	16031	13%	2	2	1
pctc_ind	0	100%	1	1	10
glob_days	0	100%	3	3	7
mult_proc	0	100%	1	1	8
bilat_surg	0	100%	1	1	5
asst_surg	0	100%	1	1	4
co_surg	0	100%	1	1	4
team_surg	0	100%	1	1	4
endo_base	18138	2%	5	5	36
physician_supervision_of_diagnostic_procedures	0	100%	2	2	10
calculation_flag	0	100%	1	1	1
diagnostic_imaging_family_indicator	0	100%	2	2	2

	Values	N	Prop
mod	26	1096	50.4%
	53	4	0.2%
	TC	1076	49.4%
status_code	A	8975	48.5%
	B	83	0.4%
	C	1156	6.2%
	E	1343	7.3%
	I	1411	7.6%
	J	276	1.5%
	M	1201	6.5%
	N	327	1.8%
	P	142	0.8%
	R	1050	5.7%
	T	8	0.0%
	X	2527	13.7%
not_used_for_medicare_payment		133	100.0%
work_rvu	0	10263	55.5%
	0.01	4	0.0%
	0.04	2	0.0%
	0.05	8	0.0%
	0.06	13	0.1%
	0.07	7	0.0%
	0.08	3	0.0%
	0.09	1	0.0%
	0.1	7	0.0%
	0.11	1	0.0%
	0.12	1	0.0%
	0.13	6	0.0%
	0.14	3	0.0%
	0.15	11	0.1%
	0.16	37	0.2%
	0.17	64	0.3%
	0.18	62	0.3%
	0.19	16	0.1%
	0.2	22	0.1%
	0.21	16	0.1%
non_fac_pe_rvu	0	9294	50.2%
	0.01	1	0.0%
	0.02	4	0.0%
	0.03	5	0.0%
	0.04	5	0.0%
	0.05	7	0.0%
	0.06	34	0.2%
	0.07	41	0.2%
	0.08	28	0.2%
	0.09	28	0.2%
	0.1	30	0.2%
	0.11	27	0.1%
	0.12	17	0.1%
	0.13	22	0.1%
	0.14	39	0.2%
	0.15	22	0.1%
	0.16	34	0.2%
	0.17	22	0.1%
	0.18	30	0.2%
	0.19	21	0.1%
non_fac_indicator	NA	4066	100.0%
facility_pe_rvu	0	9296	50.3%
	0.01	2	0.0%
	0.02	12	0.1%
	0.03	8	0.0%
	0.04	8	0.0%
	0.05	9	0.0%
	0.06	41	0.2%
	0.07	53	0.3%
	0.08	40	0.2%
	0.09	32	0.2%
	0.1	33	0.2%
	0.11	36	0.2%
	0.12	26	0.1%
	0.13	22	0.1%
	0.14	47	0.3%
	0.15	28	0.2%
	0.16	40	0.2%
	0.17	27	0.1%
	0.18	35	0.2%
	0.19	35	0.2%
facility_indicator	NA	2468	100.0%
mp_rvu	0	9311	50.3%
	0.01	911	4.9%
	0.02	554	3.0%
	0.03	345	1.9%
	0.04	286	1.5%
	0.05	214	1.2%
	0.06	199	1.1%
	0.07	147	0.8%
	0.08	158	0.9%
	0.09	168	0.9%
	0.1	126	0.7%
	0.11	108	0.6%
	0.12	107	0.6%
	0.13	73	0.4%
	0.14	88	0.5%
	0.15	65	0.4%
	0.16	84	0.5%
	0.17	50	0.3%
	0.18	38	0.2%
	0.19	48	0.3%
non_facility_total	0	9279	50.2%
	0.03	1	0.0%
	0.07	1	0.0%
	0.08	5	0.0%
	0.09	5	0.0%
	0.1	2	0.0%
	0.11	7	0.0%
	0.12	1	0.0%
	0.13	3	0.0%
	0.14	3	0.0%
	0.15	5	0.0%
	0.16	1	0.0%
	0.17	4	0.0%
	0.18	2	0.0%
	0.19	8	0.0%
	0.2	6	0.0%
	0.21	1	0.0%
	0.22	6	0.0%
	0.23	14	0.1%
	0.24	23	0.1%
facility_total	0	9279	50.2%
	0.03	2	0.0%
	0.06	1	0.0%
	0.07	1	0.0%
	0.08	5	0.0%
	0.09	11	0.1%
	0.1	4	0.0%
	0.11	8	0.0%
	0.12	2	0.0%
	0.13	3	0.0%
	0.14	2	0.0%
	0.15	5	0.0%
	0.16	2	0.0%
	0.17	5	0.0%
	0.18	2	0.0%
	0.19	8	0.0%
	0.2	5	0.0%
	0.21	2	0.0%
	0.22	9	0.0%
	0.23	15	0.1%
pctc_ind	0	7128	38.5%
	1	3229	17.5%
	2	44	0.2%
	3	178	1.0%
	4	17	0.1%
	5	104	0.6%
	6	20	0.1%
	7	74	0.4%
	8	1	0.0%
	9	7704	41.6%
glob_days	000	1326	7.2%
	010	471	2.5%
	090	3771	20.4%
	MMM	17	0.1%
	XXX	11262	60.9%
	YYY	933	5.0%
	ZZZ	719	3.9%
pre_op	0	14269	77.1%
	0.07	69	0.4%
	0.08	181	1.0%
	0.09	984	5.3%
	0.1	2483	13.4%
	0.11	361	2.0%
	0.12	133	0.7%
	0.17	19	0.1%
intra_op	0	14269	77.1%
	0.6	19	0.1%
	0.69	1408	7.6%
	0.7	200	1.1%
	0.71	140	0.8%
	0.73	27	0.1%
	0.74	133	0.7%
	0.76	482	2.6%
	0.79	69	0.4%
	0.8	587	3.2%
	0.81	487	2.6%
	0.82	28	0.2%
	0.83	181	1.0%
	0.84	469	2.5%
post_op	0	14269	77.1%
	0.07	469	2.5%
	0.09	209	1.1%
	0.1	1074	5.8%
	0.13	334	1.8%
	0.14	350	1.9%
	0.16	27	0.1%
	0.19	140	0.8%
	0.2	200	1.1%
	0.21	1408	7.6%
	0.23	19	0.1%
mult_proc	0	4044	21.9%
	2	5287	28.6%
	3	361	2.0%
	4	420	2.3%
	5	52	0.3%
	6	361	2.0%
	7	98	0.5%
	9	7876	42.6%
bilat_surg	0	7784	42.1%
	1	2203	11.9%
	2	383	2.1%
	3	237	1.3%
	9	7892	42.7%
asst_surg	0	5595	30.2%
	1	2183	11.8%
	2	2781	15.0%
	9	7940	42.9%
co_surg	0	7839	42.4%
	1	2474	13.4%
	2	301	1.6%
	9	7885	42.6%
team_surg	0	10430	56.4%
	1	133	0.7%
	2	51	0.3%
	9	7885	42.6%
endo_base	0652T	2	0.6%
	29805	11	3.0%
	29830	5	1.4%
	29840	5	1.4%
	29860	6	1.7%
	29870	15	4.2%
	31231	30	8.3%
	31505	4	1.1%
	31525	8	2.2%
	31526	7	1.9%
	31575	8	2.2%
	31622	20	5.5%
	43191	5	1.4%
	43197	1	0.3%
	43200	18	5.0%
	43235	30	8.3%
	43260	10	2.8%
	44360	9	2.5%
	44376	3	0.8%
	44380	3	0.8%
conv_factor	32.7442	18499	100.0%
physician_supervision_of_diagnostic_procedures	01	533	2.9%
	02	249	1.3%
	03	207	1.1%
	04	16	0.1%
	05	1	0.0%
	09	17465	94.4%
	21	5	0.0%
	66	1	0.0%
	6A	13	0.1%
	7A	9	0.0%
calculation_flag	0	18499	100.0%
diagnostic_imaging_family_indicator	88	444	2.4%
diagnostic_imaging_family_indicator	99	18055	97.6%
non_facility_pe_used_for_opps_payment_amount	0	17463	94.4%
	0.79	1	0.0%
	0.87	1	0.0%
	1.14	1	0.0%
	1.15	1	0.0%
	1.18	1	0.0%
	1.3	1	0.0%
	1.74	3	0.0%
	1.75	1	0.0%
	1.77	1	0.0%
	1.91	1	0.0%
	1.96	1	0.0%
	2.01	1	0.0%
	2.31	1	0.0%
	2.53	1	0.0%
	2.54	2	0.0%
	2.57	1	0.0%
	2.58	1	0.0%
	2.59	2	0.0%
	2.6	9	0.0%
facility_pe_used_for_opps_payment_amount	0	17463	94.4%
	0.79	1	0.0%
	0.87	1	0.0%
	1.14	1	0.0%
	1.15	1	0.0%
	1.18	1	0.0%
	1.3	1	0.0%
	1.74	3	0.0%
	1.75	1	0.0%
	1.77	1	0.0%
	1.91	1	0.0%
	1.96	1	0.0%
	2.01	1	0.0%
	2.31	1	0.0%
	2.53	1	0.0%
	2.54	2	0.0%
	2.57	1	0.0%
	2.58	1	0.0%
	2.59	2	0.0%
	2.6	9	0.0%
mp_used_for_opps_payment_amount	0	17463	94.4%
	0.01	77	0.4%
	0.02	71	0.4%
	0.03	107	0.6%
	0.04	131	0.7%
	0.05	108	0.6%
	0.06	59	0.3%
	0.07	41	0.2%
	0.08	36	0.2%
	0.09	37	0.2%
	0.1	41	0.2%
	0.11	33	0.2%
	0.12	48	0.3%
	0.13	26	0.1%
	0.14	38	0.2%
	0.15	27	0.1%
	0.16	17	0.1%
	0.17	14	0.1%
	0.18	6	0.0%
	0.19	4	0.0%

The MPFS is a listing of the relative value units (RVUs) for each CPT code, as well as the geographic practice cost index (GPCI) for each code. The RVUs are used to calculate the payment amount for each service, while the GPCI is used to adjust the payment amount based on the location where the service is provided.

This file contains information on services covered by the MPFS in 2024. For more than 10,000 physician services, the file contains the associated RVUs, a fee schedule status indicator, and various payment policy indicators needed for payment adjustment (i.e., payment of assistant at surgery, team surgery, bilateral surgery, etc.).

The MPFS amounts are adjusted to reflect the variation in practice costs from area to area. A GPCI has been established for every Medicare payment locality for each of the three components of a procedure’s RVU:

Physician Work
Practice Expense
Malpractice Expense (sometimes called Professional Liability Insurance)

The GPCIs are applied in the calculation of a fee schedule payment amount by multiplying the RVU for each component times the GPCI for that component.

NATIONAL PHYSICIAN FEE SCHEDULE RELATIVE VALUE FILE CALENDAR YEAR 2024

Participating

\[ x = [(RVU_w \times GPCI_w) + (RVU_p \times GPCI_p) + (RVU_m \times GPCI_m)] \times CF \]

Non-Participating

\[ y = 0.95x \]

Limiting Charge

\[ z = 0.95(1.15x) \]

Many Ways to Say the Same Thing

As there is a corresponding GPCI value for each of the three components of an RVU, the formula is essentially the dot product of the RVU and GPCI vectors, multiplied by the conversion factor:

\[ a \cdot b = a_1b_1 + a_2b_2 + a_3b_3\]

Setting up the variables:

wrvu  = 6.26   # Work RVU
wgpci = 1      # Work GPCI

pgpci = 0.883  # Practice GPCI
prvu  = 4.36   # Practice RVU

mrvu  = 0.99   # Malpractice RVU
mgpci = 1.125  # Malpractice GPCI

cf    = 32.744 # Conversion Factor

Basic Calculation:

((wrvu * wgpci) + 
   (prvu * pgpci) + 
   (mrvu * mgpci)) * cf

[1] 367.5065

With base R’s Matrix Multiplication Infix Operator:

as.vector(
  c(wrvu, prvu, mrvu) %*% 
  c(wgpci, pgpci, mgpci) * cf)

[1] 367.5065

With the pracma package’s dot() function:

pracma::dot(
  c(wrvu, prvu, mrvu), 
  c(wgpci, pgpci, mgpci)) * cf

[1] 367.5065

With the northstar package’s calculate_amounts() function:

calculate_amounts(
  wrvu  = 6.26,
  nprvu = 7.92,
  fprvu = 4.36,
  mrvu  = 0.99,
  cf    = 32.744,
  wgpci = 1,
  pgpci = 0.883,
  mgpci = 1.125
)

Facility Amounts:

RVU Total ............ 11.22
Participating ........ $367.51
Non-Particpating ..... $349.13
Limiting Charge ...... $401.50

Non-Facility Amounts:

RVU Total ............ 14.37
Participating ........ $470.44
Non-Particpating ..... $446.91
Limiting Charge ...... $513.95

Non-Facility vs. Facility

Under the MPFS, many procedures have separate payment amounts for physician services when provided in facility and non-facility settings.

The amount is determined by the Place of Service (POS) code. In general, the POS code reflects the actual place where the patient receives the face-to-face service and determines whether the facility or non-facility payment rate is paid.

Services rendered to a patient who is an inpatient of a hospital (POS code 21) or an outpatient of a hospital (POS codes 19 or 22), the facility rate is paid, regardless of where the face-to-face encounter with the patient occurred.

Therapy Code Capitation

Certain therapy codes will receive a 50% reduction to the Practice Expense.

Section 5102(b) of the Deficit Reduction Act of 2005 requires a payment cap on the Technical Component (TC) of certain diagnostic imaging procedures and the TC portions of the global diagnostic imaging services.

This cap is based on the Outpatient Prospective Payment System (OPPS) payment. To implement this provision, the Physician Fee Schedule amount is compared to the OPPS payment amount and the lower amount is used in the formula to calculate payment.

Accepting Assignment

Accepting assignment means that a healthcare provider or facility is partnered with Medicare and is required by law to charge only the Medicare-approved amount for various services. This amount is preset by Medicare and is often less than many healthcare facilities would charge.

Because of this, when patients receive care at a facility that accepts assignment, they will be required to pay lower out-of-pocket costs as Medicare will cover the full amount of the service cost. Personal costs only include the premium and any charges up to the deductible amount.

Physicians or facilities that do not accept assignment are a non-participating providers. All physicians are required to file with Medicare, indicating that they either accept or do not accept assignment. If a provider does not accept assignment, it means that they are not required to charge only the Medicare-approved amount for services.

Limiting Charge

One possible option for non-participating providers is to choose to accept assignment for some services but to decline assignment for others. For services that they accept assignment for, they are only able to bill the Medicare-approved amount. However, for other services, they are allowed to charge up to 15 percent more than the Medicare-approved amount.

This limit cap is known as the limiting charge. Providers that do not fully participate only receive 95 percent of the Medicare-approved amount when Medicare reimburses them for the cost of care. In turn, the provider can charge the patient up to 15 percent more than this reimbursement amount. This extra charge will not be covered by Medicare, which causes Medicare recipients to incur greater out-of-pocket costs.

The Medicare limiting charge is the maximum amount a Non-Participating Provider can charge for services submitted on a non-assigned claim. This is that maximum amount a beneficiary could legally be charged.

Calculation

The Medicare limiting charge is, by law, set at \(115\%\) of the payment amount for the service furnished by the Non-Participating Physician.

However, the law sets the payment amount for Non-Participating Physicians at \(95\%\) of the payment amount for Participating Physicians (i.e., the Fee Schedule amount).

Calculating \(95\%\) of \(115\%\) of an amount, \(x\), is equivalent to \(x \times 1.0925\) (or \(109.25\%\)):

# 95% of 115% of 10
(10 * 1.15) * 0.95

[1] 10.925

# 109.25% of 10
10 * 1.0925

[1] 10.925

# using the northstar package
limiting_charge(10)

[1] 10.925

Relative Value File

This file contains information on services covered by the Medicare Physician Fee Schedule (MPFS). For more than 10,000 physician services, the file contains the associated relative value units (RVUs), a fee schedule status indicator, and various payment policy indicators needed for payment adjustment (i.e., payment of assistant at surgery, team surgery, bilateral surgery, etc.).

The Medicare physician fee schedule amounts are adjusted to reflect the variation in practice costs from area to area. A geographic practice cost index (GPCI) has been established for every Medicare payment locality for each of the three components of a procedure’s relative value unit (i.e., the RVUs for work, practice expense, and malpractice). The GPCIs are applied in the calculation of a fee schedule payment amount by multiplying the RVU for each component times the GPCI for that component.

Modifiers

Status Codes

Indicates whether the code is in the fee schedule and whether it is separately payable if the service is covered. See Attachment A for description of values.

Only RVUs associated with status codes of A, R, or T, are used for Medicare payment.

PC/TC Indicator

Global Surgery Days

Provides time frames that apply to each surgical procedure.

Operative Percentages

Indicators

An NA in this field indicates that this procedure is rarely or never performed in the Facility setting:

An NA in this field indicates that this procedure is rarely or never performed in the Non-Facility setting:

Multiple Procedures

Indicates applicable payment adjustment rule for multiple procedures (modifier 51).

Payment Amount File

# northstar::search_payment()

This file contains locality-specific physician fee schedule payment amounts for services covered by the Medicare Physician Fee Schedule (MPFS) with one record for each unique combination of carrier, locality, procedure code and modifier.

`mac`	Carrier Number	Medicare Administrative Contractor ID
`locality`	Locality	Pricing Locality ID
`hcpcs`	HCPCS Code	HCPCS Code
`mod`	Modifier	Diagnostic Tests, `NA` denotes Global Service, Mods `26` & `TC` identify Components. Mod `53` indicates Separate RVUs & PFS Amount for Procedures Terminated Before Completion.
`status`	Status Code	Indicates if in Fee Schedule, if Covered, if Separately Payable. Only `A`, `R` and `T` used for Medicare payment.
`mult_surg`	Multiple Surgery Indicator	Indicates Applicable Payment Adjustment Rule: Mod `51`
`flat_vis`	Flat Rate Visit Fee	Contains Flat Visit Fee for Primary Care First Model
`nther`	Non-Facility Therapy Reduction	Fee reflects 50% PE payment for Non-facility services
`fther`	Facility Therapy Reduction	Fee reflects 50% PE payment for Facility services
`fee_nf`	Non-Facility Fee Schedule Amount	Non-Facility Pricing Amount
`fee_f`	Facility Fee Schedule Amount	Facility Pricing Amount
`opps`	OPPS Indicator	OPPS Payment Cap Determination: `1` = Applies, `9` = Does Not Apply
`opps_nf`	OPPS Non-Facility	OPPS Capped Non-Facility Pricing Amount
`opps_f`	OPPS Facility	OPPS Capped Facility Pricing Amount

GPCIs

MAC¹		Locality	Work	Practice	Malpractice
2024 Geographic Practice Cost Indices // by State & Medicare Locality
AL	10112	00 ALABAMA²	1	0.869	0.575
AK	02102	01 ALASKA	1.5	1.081	0.592
AZ	03102	00 ARIZONA	1	0.975	0.854
AR	07102	13 ARKANSAS	1	0.86	0.518
CA	01112	54 BAKERSFIELD	1.017	1.093	0.662
	01112	55 CHICO	1.014	1.093	0.56
	01182	71 EL CENTRO	1.014	1.093	0.57
	01112	56 FRESNO	1.014	1.093	0.56
	01112	57 HANFORD-CORCORAN	1.014	1.093	0.56
	01182	18 LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY)	1.042	1.194	0.69
	01112	58 MADERA	1.014	1.093	0.56
	01112	59 MERCED	1.014	1.093	0.56
	01112	60 MODESTO	1.014	1.093	0.56
	01112	51 NAPA	1.058	1.31	0.521
	01182	17 OXNARD-THOUSAND OAKS-VENTURA	1.026	1.183	0.651
	01112	61 REDDING	1.014	1.093	0.56
	01112	62 RIVERSIDE-SAN BERNARDINO-ONTARIO	1.014	1.093	0.892
	01112	63 SACRAMENTO-ROSEVILLE-FOLSOM	1.034	1.156	0.56
	01112	64 SALINAS	1.035	1.165	0.56
	01182	72 SAN DIEGO-CHULA VISTA-CARLSBAD	1.028	1.191	0.572
	01112	05 SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY)	1.088	1.419	0.445
	01112	52 SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY)	1.088	1.419	0.47
	01112	65 SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY)	1.1	1.435	0.56
	01182	73 SAN LUIS OBISPO-PASO ROBLES	1.014	1.132	0.56
	01112	09 SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY)	1.1	1.435	0.42
	01112	66 SANTA CRUZ-WATSONVILLE	1.017	1.209	0.56
	01182	74 SANTA MARIA-SANTA BARBARA	1.022	1.175	0.56
	01112	67 SANTA ROSA-PETALUMA	1.027	1.232	0.56
	01112	68 STOCKTON	1.014	1.093	0.56
	01112	53 VALLEJO	1.058	1.31	0.47
	01112	69 VISALIA	1.014	1.093	0.56
	01112	70 YUBA CITY	1.014	1.093	0.56
	01112	75 REST OF CALIFORNIA	1.014	1.093	0.56
CO	04112	01 COLORADO	1.008	1.053	0.827
CT	13102	00 CONNECTICUT	1.022	1.091	1.207
DC	12202	01 DC + MD/VA SUBURBS	1.057	1.192	1.168
DE	12102	01 DELAWARE	1.009	0.992	0.949
FL	09102	03 FORT LAUDERDALE	1	0.998	1.77
	09102	04 MIAMI	1	1.027	2.5
	09102	99 REST OF FLORIDA	1	0.94	1.467
GA	10212	01 ATLANTA	1	0.997	1.128
GA	10212	99 REST OF GEORGIA	1	0.883	1.125
HI	01212	01 HAWAII, GUAM	1	1.149	0.561
ID	02202	00 IDAHO	1	0.908	0.461
IL	06102	16 CHICAGO	1.007	1.023	2.018
	06102	12 EAST ST. LOUIS	1	0.918	1.784
	06102	15 SUBURBAN CHICAGO	1.007	1.048	1.556
	06102	99 REST OF ILLINOIS	1	0.912	1.381
IN	08102	00 INDIANA	1	0.922	0.485
IA	05102	00 IOWA	1	0.913	0.457
KS	05202	00 KANSAS	1	0.906	0.54
KY	15102	00 KENTUCKY	1	0.877	0.913
LA	07202	01 NEW ORLEANS	1	0.935	1.156
LA	07202	99 REST OF LOUISIANA	1	0.881	0.982
ME	14112	03 SOUTHERN MAINE	1	1.012	0.656
ME	14112	99 REST OF MAINE	1	0.913	0.65
MD	12302	01 BALTIMORE/SURR. CNTYS	1.02	1.078	1.309
MD	12302	99 REST OF MARYLAND	1.012	1.016	0.973
MA	14212	01 METROPOLITAN BOSTON	1.042	1.197	0.894
MA	14212	99 REST OF MASSACHUSETTS	1.017	1.061	0.796
MI	08202	01 DETROIT	1.003	0.986	1.718
MI	08202	99 REST OF MICHIGAN	1	0.911	1.173
MN	06202	00 MINNESOTA	1	1.025	0.3
MS	07302	00 MISSISSIPPI	1	0.852	0.768
MO	05302	02 METROPOLITAN KANSAS CITY	1	0.948	0.992
	05302	01 METROPOLITAN ST. LOUIS	1	0.952	0.994
	05302	99 REST OF MISSOURI	1	0.859	0.974
MT	03202	01 MONTANA³	1	1	0.978
NE	05402	00 NEBRASKA	1	0.917	0.304
NV	01312	00 NEVADA³	1	1	0.844
NH	14312	40 NEW HAMPSHIRE	1	1.034	0.898
NJ	12402	01 NORTHERN NJ	1.064	1.172	1.032
NJ	12402	99 REST OF NEW JERSEY	1.042	1.106	1.069
NM	04212	05 NEW MEXICO	1	0.908	1.172
NY	13202	01 MANHATTAN	1.065	1.166	1.656
	13202	02 NYC SUBURBS/LONG ISLAND	1.065	1.2	1.911
	13202	03 POUGHKPSIE/N NYC SUBURBS	1.046	1.106	1.269
	13292	04 QUEENS	1.065	1.195	1.462
	13282	99 REST OF NEW YORK	1	0.949	0.732
NC	11502	00 NORTH CAROLINA	1	0.926	0.665
ND	03302	01 NORTH DAKOTA³	1	1	0.517
OH	15202	00 OHIO	1	0.911	1.033
OK	04312	00 OKLAHOMA	1	0.891	0.813
OR	02302	01 PORTLAND	1.013	1.103	0.688
OR	02302	99 REST OF OREGON	1	0.986	0.643
PA	12502	01 METROPOLITAN PHILADELPHIA	1.024	1.053	1.177
PA	12502	99 REST OF PENNSYLVANIA	1	0.927	0.925
PR	09202	20 PUERTO RICO	1	1.007	0.982
RI	14412	01 RHODE ISLAND	1.025	1.039	0.849
SC	11202	01 SOUTH CAROLINA	1	0.913	0.817
SD	03402	02 SOUTH DAKOTA³	1	1	0.382
TN	10312	35 TENNESSEE	1	0.896	0.544
TX	04412	31 AUSTIN	1	1.046	0.914
	04412	20 BEAUMONT	1	0.903	0.947
	04412	09 BRAZORIA	1.014	1.006	0.795
	04412	11 DALLAS	1.011	1.007	0.877
	04412	28 FORT WORTH	1.011	0.998	0.902
	04412	15 GALVESTON	1.014	1	0.855
	04412	18 HOUSTON	1.014	1.003	1.409
	04412	99 REST OF TEXAS	1	0.945	0.934
UT	03502	09 UTAH	1	0.933	0.93
VT	14512	50 VERMONT	1	0.993	0.518
VA	11302	00 VIRGINIA	1.002	0.984	0.755
VI	09202	50 VIRGIN ISLANDS	1	1.007	0.982
WA	02402	02 SEATTLE (KING CNTY)	1.043	1.22	0.853
WA	02402	99 REST OF WASHINGTON	1.007	1.04	0.803
WV	11402	16 WEST VIRGINIA	1	0.862	1.333
WI	06302	00 WISCONSIN	1	0.957	0.331
WY	03602	21 WYOMING³	1	1	0.739
Note: The Further Continuing Appropriations and Other Extensions Act, 2024 (Section 501) extended the 1.0 Work GPCI floor through January 19, 2024. Therefore, the Work GPCIs for 2023 reflect the 1.0 Work GPCI floor. Work GPCIs for 2024 are shown both with and without a 1.0 floor and Work GPCIs for 2025 do not reflect a 1.0 floor.
¹ MAC assignments as of November 22, 2023
² Work GPCI reflects a 1.5 floor in Alaska established by MIPPA.
³ PE GPCI reflects a 1.0 floor for Frontier States established by the ACA.